Gynaecology triage

Obstetrics and gynaecology induction toolkit [Pilot-live]
NHS Lothian

Location: Gynaecology triage is based in the Outpatient Department from 09:00–16:30 and moves to Ward 210 thereafter.

For advice, follow this escalation process:

  1. Primary contact: Gynae triage registrar – pager 1625
  2. Secondary contact: Senior registrar (covering Labour Ward) – pager 1616
  3. Final contact: On-call consultant (mobile number available in the phonebook)

The two key EMERGENCY conditions the registrar will want to be informed about as soon as possible are:

How it works

From 09:00 to 16:30, Gynae triage is located in the gynaecology outpatient corridor, which has two rooms for seeing patients.

At 16:30, triage moves to the treatment room on Ward 210, of which there is only one. This may sometimes result in a backlog. It is crucial that when accepting out-of-hours referrals, the registrar communicates with the nurse in charge of the ward regarding the bed availability.

The gynaecology registrar handles referrals via pager 1625. During daytime hours, patient details are posted on the triage board.

Out of Hours

If a patient does not require immediate attention, their details are placed in the triage referral folder (blue folder, stored in the drawers under base A in Ward 210). These are then reviewed by the nurse in charge the following morning, and the patient will be contacted the next day with an appointment time. You no longer need to request scans, as nursing staff will arrange these if the necessary information is provided in the referral sheet.

Nursing staff usually assess the patient first, performing observations, urinalysis, and pregnancy tests. They will then be placed in the "awaiting medical review" pile. The tier 1 doctor should review the patient and, if necessary, discuss the case with the registrar.

Gynae triage shifts offer a valuable opportunity to assess and manage a wide range of acute gynaecological emergencies. There are often chances to perform minor procedures such as abscess drainage, removal or insertion of coils, etc.

It can feel busy due to space limitations in the department. If your registrar or consultant is in theatre, do not hesitate to reach out to the senior registrar on pager 1616 or another consultant within the department.

Ultrasound scans (USS)

The referral history often indicates the need for a pelvic ultrasound. In such cases, we are asked to arrange the scan before seeing the patient to ensure it is done in a timely manner.

There are four designated scan slots for gynae triage each day, which will be added to the diary. The scan department also accepts additional requests and will try to accommodate them if possible, provided the request is made on TRAK.

Be sure to wait for the secretarial staff in triage to create the gynae triage episode for the patient before submitting the scan request. Otherwise, the request may end up in the outpatient queue and not be assigned a time slot.

For urgent scans, it can be helpful to visit the scan department directly to speak with the sonographers.

Examination

A chaperone should always be present during any intimate examination.

Paperwork

A brief discharge letter should be completed for every patient seen in gynae triage using the template \gytr in the discharge letters tab.

Results should be followed up by the tier 1 doctor in gynae triage the following week. For instance, if you are covering gynae triage on a Monday, review the previous Monday's list and sign off any outstanding results from that day.

Also, check for out-of-hours results in the diary on Ward 210 and the 'Ward 210 Attendee' clinic list, as these are often overlooked.

Any abnormal results must be communicated to the patient by phone, although you can discuss them with the registrar first if there is any uncertainty.

No action is required for normal results, and this should be communicated to patients when taking swabs in GTA.

Helpful Protocols

A protocol titled "Painful Gynaecological Conditions" is available on the intranet, providing valuable information.

Additionally, there are other useful protocols for both obstetrics and gynaecology under the Reproductive Medicine section in the intranet A-Z directory (you may need to be logged onto the NHS Lothian network to access the intranet).

Editorial Information

Last reviewed: 09/03/2025

Next review date: 01/08/2025

Reviewer name(s): Helen Brauer.